36D2059822 CLIA NUMBER - KROGER PHARMACY #641

Laboratory Demographics

  • CLIA Code: 36D2059822
  • Facility Name: KROGER PHARMACY #641
  • Facility Address: 2028 E HARBOR RD
    PORT CLINTON, OH
    ZIP 43452
  • Facility Phone: 419 732-6452
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JEFF STECKMAN
  • NPI Number: 1295769917
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 36D2059822
LAB Type Pharmacy
Facility Name KROGER PHARMACY #641
Street 2028 E HARBOR RD
City PORT CLINTON
State OH
ZIP 43452
Phone 419 732-6452
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/31/2025
Certificate Expiration Date 5/30/2027
Facility Type Pharmacy
Lab Director JEFF STECKMAN

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This page was last updated on: 9/29/2025